The role of surveillance systems in confronting the global crisis of antibiotic-resistant bacteria.
The role of surveillance systems in confronting the global crisis of antibiotic-resistant bacteria.
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DOI：
10.1097/qco.0000000000000182
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发表时间：
2015-08
影响因子：
3.9
通讯作者：
Villegas MV
中科院分区：
文献类型：
--
作者：
Perez F;Villegas MV
人们普遍认为，感染控制，先进的诊断和新的治疗方法对于减轻耐药细菌的影响至关重要。全球、国家和区域监测系统作为应对抗生素耐药性挑战的一部分的作用没有得到充分强调。我们提供了一个当代监测计划的概述，重点是革兰氏阴性菌。世界卫生组织和欧洲及美国的公共卫生机构最近发表了全面的监测报告。这些突出了碳青霉烯类耐药肠杆菌科（CRE）和其他多重耐药革兰氏阴性菌的出现和传播。在以色列，控制CRE的公共卫生行动，特别是产生碳青霉烯酶（KPC）的肺炎克雷伯菌，已经取得了进展，同时对其流行病学有了更好的了解。正在制定适合各国要求和能力的监测模式。强有力的监测系统对于对抗抗生素耐药性至关重要，需要强调“同一健康”的方法。监测的改进将来自生物信息学和基因组学的进步，这些进步允许整合有关人类和动物抗生素消耗、耐药性分子机制和细菌基因分型的全球和地方信息。
It is widely accepted that infection control, advanced diagnostics, and novel therapeutics are crucial to mitigate the impact of antibiotic-resistant bacteria. The role of global, national and regional surveillance systems as part of the response to the challenge posed by antibiotic resistance is not sufficiently highlighted. We provide an overview of contemporary surveillance programs, with emphasis on Gram-negative bacteria. The World Health Organization and public health agencies in Europe and the United States recently published comprehensive surveillance reports. These highlight the emergence and dissemination of carbapenem-resistant Enterobacteriaceae (CRE) and other multidrug resistant Gram-negative bacteria. In Israel, public health action to control CRE, especially Klebsiella pneumoniae carbapenemase (KPC) producing-Klebsiella pneumoniae, has advanced together with a better understanding of its epidemiology. Surveillance models adapted to the requirements and capacities of each country are in development. Robust surveillance systems are essential to combat antibiotic resistance, and need to emphasize a “One Health” approach. Refinements in surveillance will come from advances in bioinformatics and genomics that permit the integration of global and local information about antibiotic consumption in humans and animals, molecular mechanisms of resistance, and bacterial genotyping.